Prealbumin, C Reactive Protein to Prealbumin Ratio and Their Association with Nt-Probnp In Patients with And Without Major Cardiovascular Disease or Chronic Renal Failure

Abstract

Livy Nicolas, Yann Ancedy, Jean-Pierre Clotilde, Frederic Martino, Rosan Fanhan, and Lydia Foucan

We aimed to investigate the association between prealbumin (PAB) and C reactive protein to prealbumin (CRP/PAB) ratio, as markers of inflammation and/or malnutrition and NT-proBNP in patients with or without major cardiovascular disease (MCVD) or chronic renal failure (CRF). Methods: Overall, 303 individuals, with available data for NT-proBNP levels and echocardiographic examination, were included in the study. Results: Mean age was 75.63 ± 9.79 years and 56.4 % were categorized as Non MCVD - non CRF. NT-proBNP concentrations ranged from 16 to 35572 pg/mL . In the non MCVD - non CRF group a higher NT-proBNP level was noted in the individuals having at least 3 factors of undernutrition than in the others (141.00 [84.75 – 346.00] pg/mL vs 91.00 [49.00 – 197.00] pg/mL respectively; P = 0.012), Log NT-proBNP was positively correlated with age and negatively correlated with albumin and PAB levels in both groups. In individuals without MCVD and CRF unlike the others, log NT-proBNP was not significantly correlated with CRP levels, CRP/PAB ratio, creatinine levels, creatinine clearance or left ventricular ejection fraction (LVEF). With the multivariate linear regression in the whole study population significant effects on log NT-proBNP were noted, for age (P< 0.001), MCVD (P < 0.001), PAB (P < 0.001) and creatinine levels (P < 0.001). The effect of body mass index (BMI) was nearly significant (P = 0.051). Gender, log CRP, CRP/PAB ratio, hypertension and diabetes did not contribute significantly to the model. Conclusion: Prealbumin, a marker of both inflammation and malnutrition is strongly associated with NT-proBNP independently of MCVD and creatinine levels. In patients without MCVD and CRF, NT-proBNP levels could help to assess for the risk of inflammation-malnutrition especially in the older.

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